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Monday, 17 September 1973
Page: 1063

Dr JENKINS (Scullin) - In addressing myself to this Bill I feel that I should first of all reply to one of the matters raised by the honourable member for Herbert (Mr Bonnett). As he said, there has been a reduction which will be balanced by an equivalent increase in the general rate pension and will therefore not result in any actual loss of money to those involved in the special compensation allowance paid to most general rate pensioners in the 75 per cent to 100 per cent range. The allowance is at present $4.50 at the 75 per cent level, increasing to $6 at the 100 per cent level. This will be reduced by half by this Bill, and the Minister for Repatriation (Senator Bishop) has indicated that in the autumn the remainder will be withdrawn.

The Government Party has never favoured this allowance, which the previous Government introduced in 1968 as a means of increasing only the upper quarter of the general rate range. It did .this probably to avoid the very high expenditure of an increase across the board. If the honourable member for Herbert is surprised to hear this perhaps he ought to read the reasons that the Government Party, then .the Opposition, gave at the time for this. The Government is interested in producing a compensation and pension structure which is fair across the board and which will continue to increase as the needs of the per sons are increased and not just some sort of structure which has bits of sticking plaster stuck on it here and there such as the structure which enabled the former Government to avoid its responsibilities.

I too support the Bill because, as promised, there are substantial improvements in repatriation payments for ex-servicemen. There is also in the Bill the extension of benefits to members of the regular forces, and there is an indication of the interlocking of repatriation benefits with general health and social welfare services in the community. I am surprised to hear the rumour that the honourable member for Herbert raised. I can only assume that this matter of interlocking repatriation services with other health and social welfare services gave rise to that rumour. Never at any stage have we suggested that the repatriation benefits should be denied to those who are qualified for them. But there is considerable expertise in the Repatriation Department which has much to add to community health and social welfare services, and I do not .think those with that expertise should be prevented from giving that assistance. Indeed in this legislation the Minister has made provision for such assistance to be given. For too long there has been an artificial division and lack of integration and a failure to exchange the real expertise that exists.

I think we all acknowledge that it is a time of changing requirements for the Repatriation Department. One regrets that perhaps some of the changes made in this Bill had not been made earlier when much greater benefit could have been given. The extension of benefits to members of the regular forces is part of making the Services more attractive to individuals. Extending benefits to national servicemen who undertook to complete their periods of full time service was a promise made to members who gave that undertaking. It has caused some concern in the community in aspects other than repatriation for some of the former national service members of the forces, who feel aggrieved that because they completed their service before 7 December last they were not able to get some of the other benefits that existed. But another government controlled the Repatriation Department until December of last year for a period of 23 years, and it would be impossible for this Government to make up for all the deficiencies in the policy decisions that were made in those 23 years.

I believe that the making of regulations in this Bill requiring determining authorities established under the Repatriation Act to provide reasons for their decisions is a very good provision. I know that the honourable member for Herbert in addressing himself to the Bill speaks with a deep knowledge of the armed Services and the problems that the returned serviceman has in confirming that those disabilities are due to service.

I have had considerable experience with repatriation patients, firstly in my capacity as a medical practitioner and then of course in my capacity as a member of Parliament. It always seems that in the areas of entitlement the Press publicity is given to those members of the profession and those people who talk about the so called bludgers who receive repatriation entitlements when they should not receive them. In my experience there is a very large number who miss out on repatriation entitlements although to my way of thinking they are very much entitled to them. So I welcome this suggestion that those whose applications for acceptance of a disability to be recognised have been refused will now be given reasons for the decision. In this way they will be better able to present their cases before the various tribunals.

I turn to some matters with regard to these various tribunals which determine an exmember's entitlement. I feel that long before this we probably should have accepted a greater deal of regionalisation of tribunals. I recently visited a country centre in the Mildura area of Victoria. In talking to some of the ex-members there it was pointed out to me that great disabilities are suffered by persons who make applications and have to appear before the tribunals. Often they have to fly to Melbourne. They see their advocate before the tribunal only minutes before they appear before the tribunal and in fact are disadvantaged by this. As well as providing reasons, perhaps consideration should be given to taking note of the difficulties that some of these ex-members have in preparing their cases adequately and to some of the disadvantages they have in travelling long distances to appear before the tribunals.

In that sense probably the honourable member for Herbert and I were as one in asking that in reviewing tribunal decisions and the functioning of tribunals the maximum degree of benefit of the doubt be given to the ex-member. I think this is basic to our concept of repatriation and that even after all these years of functioning of the Department improvements can still be made. I welcome the suggestion that the Repatriation Commission will now provide medical hospital treatment to all Boer War and 1914-18 War veterans in respect of all disabilities. I do not suppose that this change is terribly generous. There would be so few Boer War veterans left. But indeed for the large number of 1914-18 War veterans I think it is a wise move.

Like many other members of the House, I am too young to know much about that war or in fact the decade or so after it. However, I have had experience of ex-servicemen who were concerned with repatriation and they have informed me that at the end of that war so many of them just wanted to get out and get into civilian life that they accepted an Al discharge so long as it meant that they got their discharge. Out they went. Years later when they found small disabilities, that had been aggravated by time and they made claims they were told that their records showed that they were fit when they were discharged. Their disabilities were not recognised. We have now come to a stage where we as a community can well afford to accept those disabilities, and I commend the Minister for Repatriation for having taken this action. With regard to the provision of treatment for those ex-servicemen who have served in a threatre of war and are suffering from cancer, one sees this as an offer for such people to be able to use repatriation facilities. In looking at why we should offer repatriation facilities to people with malignant growths, I suppose the only reason is one of compassion and the complete lack of real knowledge of how neoplasia occurs.

I would have thought there were other conditions to which we could give consideration. There is considerable discussion about the role that stress and strain can play in cardiovascular degeneration and it would be undoubted that many of these ex-servicemen have undergone quite long periods of stress and strain. Conditions of wartime service place them in positions where there may be pulmonary damage which does not evidence itself until much later in the form of emphysema and such complaints. Many of those with multiple gunshot wounds and injuries to limbs and various parts of the body later develop crippling arthritis and are incapacitated for work. I have found from a number of cases that have been brought to my attention, either as a doctor or as the local member, that osteoarthritis developing in later years in ex-servicemen who have had multiple injuries has not been accepted as a repatriation entitlement. Yet I seem to remember as a medical student being told that if a person receives a broken limb in a motor car accident he is sure to have osteoarthritis in certain joints as a result. I wonder whether we could not afford to be more generous in recognising these conditions for the provision of repatriation, medical and hospital treatment.

There is also provision for repatriation hospitals and institutions to be used to provide in-patient treatment for persons other than ex-servicemen and their dependants. I think it has been made quite clear that this provision will not be used while there is a demand for hospital beds by persons entitled to repatriation treatment. It is true that from time to time many repatriation hospital beds are available. I live in the same area as the Heidelberg Repatriation General Hospital. I can remember as a schoolboy seeing the hospial being built on the dairy farm that existed there before it From time to time the Heidelberg Repatriation General Hospital has had wards closed due to either a shortage of patients or a shortage of staff. I suppose that if one drew a straight line about 3 miles long starting at the Austin Hospital it would include the Austin Hospital, the Repatriation General Hospital and the Preston and Northcote Community Hospital. Yet, despite there being 2 other institutions, there is still a high demand for hospital beds in the area and the Repatriation General Hospital is very well placed, if it has beds available, for use by ordinary members of the community. In fact discussions are taking place between representatives of those hospitals' for a reciprocal arrangement, for the exchange of medical staff and looking after the patients in those institutions. It is difficult to judge just how many beds will be made available in this way for the general use of patients other than exservicemen and their dependants, but it is certainly better for those beds to be used than for them to lie idle or for wards to be closed.

Finally I want just to mention the other provision in this Bill concerned with the provision and repair of artificial limbs for persons other than ex-servicemen and their dependants. In this area I suppose no other department and no other organisation in Australia would have more expertise than the Repatriation Department The very number of ex-personnel who have had to use the services of the Department has meant that those working with prostheses have had a wide range of experience. They have had the benefit of being able to try new methods, and this can all be used for the benefit of exservicemen and people other than ex-servicemen in the community. With suitable artificial limbs the number who can return to normal activity is remarkable. Yet if the individual has to get these prostheses from other sources the cost is tremendously high. For instance, recently I had a case involving a man with an above-knee amputation. An artificial limb for him would cost somewhere about $360. Because of a poorly formed stump he had to change this limb fairly frequently. The very fact of having an artificial limb enabled this man to carry out his normal everyday occupation and therefore he was not claiming any social welfare benefits. But the cost of over $300 for a suitable artificial limb was a real strain on him.

I congratulate the Minister for bringing in this provision with regard to artificial limbs. The Repatriation Department has a lot of other expertise in the field of prostheses. I trust that as the demand from ex-servicemen decreases this expertise will be used to benefit other members of the community. I think this Bi'l does indeed contain very significant changes in the repatriation field. I do not think there has been as comprehensive a look at repatriation benefits for many years and I am proud to have had the opportunity to speak briefly on the Bill.

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